Question on Lantus Dosing

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Celia

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I'm new. My 16-year-old Himalayan Dusty has been on Lantus since August 2009--1 unit 2 x a day. Due to episodes of possible hypoglycemia in April, my vet had me put him on 1 unit 1 x a day. Then she tried 1-1/2 units 1 x a day. Her curve showed severe lows in the day. Then it was high at night. I've started testing at home (with her blessing). From everything I've read and my history with Dusty and now my testing at home, he needs to be on 2 x a day dosing. Before I talk to my vet, I wanted to post here. He has been on the once daily dosing since early April. Should he return to 1 unit 2 x a day immediately or 1/2 unit 2 x a day for a few days and then 1 unit 2 x a day. Thanks for any help at all.
 
hi and welcome!

based on what you said in your post, i'd go to 1/2 unit twice a day and go up from there if need be. the one unit clearly was too much if he was hypo'ing on it. and once a day dosing with lantus doesn't work except in a very rare case so 1/2 unit twice a day is what i would do. and now that you're hometesting you can better see what is an appropriate dose as you go along
 
Lantus needs to be dosed 2x to be effective. Please share this document with your vet: http://www.uq.edu.au/ccah/docs/diabetesinfo/link5.pdf, and point out where it says "When SID dosing is desired or demanded (it is important to note that better glycemic control and higher remission rates will be obtained with BID dosing. SID dosing only provides similar control and remission rates to lente BID)." Here is a link to the Lantus dosing protocol for you to also share with your vet: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf. I've also attached an article that explains the efficacy of this protocol as well to give to your vet. The very high remission rates with Lantus are only proven to be valid when this specific protocol is followed.

Since 1u was too much insulin, the dose should have been reduced to .75u twice a day instead of shooting 1u once a day.

I would restart BID dosing with .5u twice a day and see if that dose is effective. If it's not, raise to .75u twice a day. Sometimes even .25u increments are too drastic a dose change for cats, and you need to raise or lower the dose by shooting a "skinny" or a "fat" shot. Check out the stickies in the Lantus forum for more information: http://felinediabetes.com/FDMB/viewforum.php?f=9. This thread has pictures that show you how to measure the smaller dose changes: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139.

Is dusty on a low carb (less than 10%), canned only diet?
 

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Thanks to Cindy & Mousie and Julie & Bandit. Julie--I posted another topic about .75 unit dosing. Sorry, I'm new and not sure how this works (about new topics). Thanks.
 
He has been on canned wet since he was diagnosed in August 2009. I use Fancy Feast Classic varieties--Classic Chicken, Chunky Chicken and Turkey and Giblets. I try to keep him on the Classic Chicken, but he gets picky and wants the others for awhile. He was thin all his life but had pancreatitis for years which is what we believe precipitated the diabetes. He long ago quit eating the food the vet put him on originally for pancreatitis (Hill's I/D), so I haven't checked to see if it is suitable for diabetics.
 
Celia said:
He has been on canned wet since he was diagnosed in August 2009. I use Fancy Feast Classic varieties--Classic Chicken, Chunky Chicken and Turkey and Giblets. I try to keep him on the Classic Chicken, but he gets picky and wants the others for awhile. He was thin all his life but had pancreatitis for years which is what we believe precipitated the diabetes. He long ago quit eating the food the vet put him on originally for pancreatitis (Hill's I/D), so I haven't checked to see if it is suitable for diabetics.


The Fancy Feast classics are all low carb, so that's great. Does he handle them fine with his pancreatitis? If so I would stick with them. If not, there are some lower fat, lower carb foods you can try.

I was asking because if his insulin need is going down, removing high carb food can push that need down even further. You've already removed the high carb food, so you're good.

There is no Hills food, Prescription or Science Diet, that is appropriate for a diabetic cat (Even their diabetic prescription diet!). They have some of the worst ingredients and carbohydrate contents of any food out there.
 
Julia, thanks so much for your help. As for the pancreatitis, Dusty handles the Fancy Feast as well as he ever did the prescription I/D the vet gave me. If I ever find I need a different food, I'll post again for some ideas. Dusty has been high maintenance at times in recent years, but I love him and want him with me as long as possible. He's been with me 16 years, and I haven't been so lucky with all my "furry children" over the years.

Your Bandit brings a smile. My Star and Mandy, two seal-point Himalayan half-sisters who are gone now, had Bandit's coloring but with the long fur. Guess that's why he reminds me of them. What a wonderful little face he has.

Thanks again. What a great place for information. I'm glad I found it.
 
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